Treatment of stomach cancer is varied and depends on the age of patient, health, extent of spread, location and other co-morbid conditions. If in doubt about the type of treatment, one should always seek a second opinion
The goal of any cancer treatment is to completely get rid of the cancer. Often this is not possible and the oncologist may decide on palliative care. This simply means offering treatment that will improve the quality of your life.
Treatment Options
Surgery is the standard treatment for stomach cancer. However, the extent of surgery may depend on location of the tumor and degree of spread. There are a variety of different stomach resection procedures. In most cases, the surgery involves removal of at least 2/3rd or ¾th of the stomach to ensure that the cancer is removed.
The residual stomach is then reconstructed with a piece of bowel. All the adjacent lymph nodes around the stomach are sampled and removed to determine if spread has occurred. The current trend is to administer chemotherapy for several months prior to undertaking surgery.
There are many instances when the surgeon attempts to perform surgery only to discover that the cancer has spread extensively. In such cases, only a palliative procedure is performed to alleviate the obstruction and improve the quality of life. Stomach surgery is complex and technically demanding. Complications can and do occur. The most common side effects after surgery include diarrhea, vomiting, frequent bowel movements after eating, cramping and dizziness.
Chemotherapy is frequently used to treat stomach cancer. The chemotherapeutic drugs are given intravenously or orally. In all cases, a combination of these drugs is used to prevent the development of resistance. Often chemotherapy is used in conjunction with surgery to control any residual tumor. Chemotherapeutic regimens are offered in cycles to allow the body to recover and determine the response to treatment.
Chemotherapeutic drugs do have some side effects which can range from lethargy, diarrhea, loss of hair, fatigue, anemia, bleeding and susceptibility to infections. Two common side effects of chemotherapeutic drugs include nausea and vomiting. However, the availability of newer anti emetic medications has made these side effects tolerable.
Radiation therapy utilizes high beam energy to kill cancer cells. Radiation is never the sole treatment of stomach cancer. In all cases it is part of a treatment regimen involving surgery and/or chemotherapy. There are many protocols for radiation therapy. In general, one receives daily radiation treatments for 5-6 weeks. Side effects of radiation therapy include nausea, vomiting, hair loss, diarrhea and fatigue
Antibiotics have recently been used to treat certain lymphomas which have grown due to the presence of H pylori. These antibiotics kill the H pylori and result in elimination of the lymphoma. Even though the lymphoma may respond, long term surveillance is vital to ensure that there is no recurrence.
Other Treatment Options
TARGETED DRUG THERAPY
In the last decade, targeted immunotherapy has been developed to treat stomach cancers. Drugs like imatinib or mesylate (Gleevec)can be administered by mouth and target a specific genetic mutation within cancer cells. The great advantage of such therapy is that the normal healthy tissues are not affected and thus, the side effects are minimal. Compared to other types of cancer treatment, the side effects with immunotherapy are mild and include fluid retention, nausea, muscle pain/cramps and skin rashes.
Imatinib unfortunately is not for all individuals with stomach cancer. Only those individuals who have a gastric cancer with a specific genetic mutation are candidates. Even then, surgery is still the gold standard for stomach cancers.
CLINICAL TRIALS
The National Cancer Institute website has a list of the currently available clinical trials being conducted in various US medical centers. To enter a clinical trial is free. The trials use different drugs, immunomodulators and offer alternative treatment which are not part of conventional treatment for gastric cancer.
If you have advanced stomach cancer, you may want to consider participating in a clinical trial. However, one has to remember that the clinical trials are experimental and not proven to be effective. In addition, there is always a chance that one may develop serious side effects and complications.
On the positive side, the trials are closely monitored, free to enter and all precautions are taken to ensure that the treatment will be safe. And if you are lucky, perhaps you may have found a cure to your cancer.
The National Cancer Institute’s Cancer Information Service at 800-4-CANCER, or 800-422-6237 offers decent advice and can answer most of your questions.
